title: Predictive factors for new onset or progression of knee osteoarthritis one year after trauma: MRI follow-up in general practice.
abstract: OBJECTIVE
  To prospectively evaluate prognostic factors for new onset or progression of degenerative change on follow-up MRI one year after knee trauma and the association with clinical outcome.
  
  
  METHODS
  Within a prospective observational cohort study in general practice, we studied a subgroup of 117 patients with acute knee trauma (mean age 41 years, 43% women). Degenerative change was scored on MRI at baseline and after one year follow-up. Multivariate logistic regression analysis was performed to evaluate prognostic factors for new onset or progressive degenerative change on follow-up MRI. Association between new or progressive degeneration and clinical outcome after one year was assessed.
  
  
  RESULTS
  On follow-up MRI 15% of patients with pre-existing knee osteoarthritis showed progression and 26% of patients demonstrated new degenerative change. The only statistically significant prognostic variable in the multivariate analysis was bone marrow oedema on initial MRI (OR 5.29 (95% CI 1.64-17.1), p = 0.005). A significant association between new or progressive degenerative change and clinical outcome was found (p = 0.003).
  
  
  CONCLUSIONS
  Bone marrow oedema on MRI for acute knee injury is strongly predictive of new onset or progression of degenerative change of the femorotibial joint on follow-up MRI one year after trauma, which is reflected in clinical outcome.
authors.affiliation: Department of Radiology, Maasstad Ziekenhuis, Postbus 9100, 3007 AC, Rotterdam, The Netherlands.
authors.forename: Ingrid M
authors.initials: IM
authors.lastname: Koster
authors.forename: Edwin H G
authors.initials: EH
authors.lastname: Oei
authors.forename: Jan-Hein J
authors.initials: JH
authors.lastname: Hensen
authors.forename: Simone S
authors.initials: SS
authors.lastname: Boks
authors.forename: Bart W
authors.initials: BW
authors.lastname: Koes
authors.forename: Dammis
authors.initials: D
authors.lastname: Vroegindeweij
authors.forename: M G Myriam
authors.initials: MG
authors.lastname: Hunink
authors.forename: Sita M A
authors.initials: SM
authors.lastname: Bierma-Zeinstra
mesh_terms: D000293:Adolescent; D000328:Adult; D018450:Disease Progression; D005260:Female; D058006:General Practice; D006801:Humans; D007718:Knee Injuries / Q000150:complications*; D016015:Logistic Models; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000209:etiology* / Q000473:pathology*; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors